1497750830 NPI number — ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.

Table of content: (NPI 1497750830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497750830 NPI number — ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASPIRUS IRON RIVER HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497750830
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29980 NETWORK PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60673-1299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
906-265-6121
Provider Business Mailing Address Fax Number:
906-265-0741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 W ICE LAKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRON RIVER
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-265-6121
Provider Business Practice Location Address Fax Number:
906-265-0741
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PECK
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
VP REVENUE CYCLE
Authorized Official Telephone Number:
715-847-2988

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  231318 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00251 . This is a "BCBS OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5170934 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1557220 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com